In hyperparathyroidism, skeletal changes occur in 13 per cent of severe and long-standing cases (Smith, 1979). These skeletal changes vary from generalized demineralization of bone in early cases to resorption of bone marrow and replacement by fibrous tissue with cystic changes, the latter being termed osteitis fibrosa cystica or brown tumour. These cystic tumours are rare and usually occur in the long bones. Osteitis fibrosa cystica rarely presents in the maxilla as the initial symptom of hyperparathyroidism.